Asthma is defined as a chronic inflammatory disorder of the airways, with severe asthma causing inflammation that is harder to treat1,2
Asthma related chronic inflammation is associated with airway hyperresponsiveness that leads to recurrent symptoms of wheezing, breathlessness, chest tightness and coughing1
Symptoms are often associated with widespread or variable airflow obstruction within the lung that is often reversible either spontaneously or with treatment options1
Severe asthma refers to asthma which does not get better with the usual treatment leaving patients with breathing problems most of the time, meaning that a different treatment approach may be necessary to control the symptoms3,4
Potential severe asthma triggers
Certain triggers of asthma may lead to the development and worsening of severe asthma symptoms5,6
Common asthma triggers include:
Infections
Allergies
Smoke, fumes and pollution
Medicines
Emotions
Weather changes
Mould or damp
Exercise
Considerations of comorbidities with severe asthma
The majority of patients with severe asthma present with comorbidities, which can include chronic rhinosinusitis, nasal polyposis and allergic rhinitis6,7
Identifying other comorbidities are important in the management of severe asthma, as they may contribute to poor disease control leading to symptom aggravation, as well as mimicking symptoms7
Severe asthma is a complex and heterogeneous disease that should be treated with a personalised approach therefore, appropriate diagnosis and management of severe asthma is critical6
DUPIXENT is the first biologic for the treatment of severe asthma to inhibit signalling of Type 2 cytokines, IL-4 and IL-138
DUPIXENT is indicated in patients 6 years and older as add-on maintenance treatment for severe asthma with Type 2 inflammation characterised by:8
raised blood eosinophils (EOS)
and/or raised fraction of exhaled nitric oxide (FeNO)
who are inadequately controlled with high-dose (ages 12 and older) and medium-to-high dose (ages 6 to 11) inhaled corticosteroids (ICS) plus another medicinal product for maintenance treatment
Challenge of severe asthma
Patients with severe asthma risk premature mortality and corticosteroid-related morbidities3,4,9,10
Complexity of Type 2 inflammation
No single biomarker fully captures the complexity of Type 2 inflammation in asthma11–16
Severe asthma: Mode of disease
IL-4 and IL-13 are key drivers of Type 2 inflammation in severe
asthma11,12,17,18
DUPIXENT patient profiles
What type of severe asthma patients can benefit from DUPIXENT?
- Cukic V, et al. Mater Sociomed. 2012;24(2):100–105.
- American Lung Association. Severe asthma. Available at: May 2023 https://www.lung.org/lung-health-diseases/lung-disease-lookup/asthma/learn-about-asthma/severe-asthma. Date last accessed: May 2023.
- Asthma UK. What is severe asthma? Available at: https://www.asthma.org.uk/advice/severe-asthma/what-is-severe-asthma/. Date last accessed: May 2023.
- Asthma UK. Severe asthma: the unmet need and the global challenge. Available at: https://www.asthma.org.uk/globalassets/get-involved/external-affairs-campaignspublications/severe-asthma-report/auk_severeasthma_2017.pdf. Date last accessed: May 2023.
- NHS UK. Asthma causes. Available at: https://www.nhs.uk/conditions/asthma/causes/. Date last accessed: May 2023.
- Jones TL, et al. Clin Med (Lond). 2018;18(Suppl2):s36–s40.
- Porsbjerg C and Menzies-Gow. Respirology. 2017;22(4):651–61.
- DUPIXENT Summary of Product Characteristics, 2023.
- Sweeney J, et al. Thorax. 2016;71(4):339–346.
- Why asthma still kills. The National Review of Asthma Deaths (NRAD). May 2014. Available at: https://www.rcplondon.ac.uk/projects/outputs/why-asthma-still-kills. Date last accessed: May 2023.
- Seys SF, et al. Respir Res. 2017;18:39.
- Peters MC, et al. J Allergy Clin Immunol. 2014;133(2):388–394.
- Peters MC, et al. J Allergy Clin Immunol. 2019;143(1):104–113.e14.
- GINA. Global Initiative for Asthma. Global Strategy for Asthma Management and Prevention, 2020. Available at: https://ginasthma.org/wp-content/uploads/2020/06/GINA-2020-report_20_06_04-1-wms.pdf. Date last accessed: May 2023.
- Amaral R, et al. Clin Transl Allergy. 2018;8:13.
- Silkoff PE, et al. J Allergy Clin Immunol. 2017;140(3):710–719.
- Tran TN, et al. Ann Allergy Asthma Immunol. 2016;116(1):37–42.
- Doran E, et al. Front Med. 2017;4:139.
EOS, eosinophils; FeNO, fractional exhaled nitric oxide; ILC, innate lymphoid cells; IL, interleukin; IgE, Immunoglobulin E; OCS, oral corticosteroids; Th, t-helper.
References
MAT-GB-2004973 (v8.0) | Date of preparation: May 2023